Myelodysplastic syndrome or MDS

Myelodysplasia refers to a set of syndromes (also called myelodysplastic syndromes, or MDS) in which the normal process of making mature blood cells (red blood cells, white blood cells, and platelets) – known as hematopoiesis – is impaired.  Hematopoiesis begins with a hematopoietic stem cell (HSC) present in the bone marrow. The HSC is capable of differentiating into two more specialized stem cells: lymphoid stem cells and myeloid stem cells. Lymphoid stem cells differentiate into a type of white blood cell called a lymphocyte, while myeloid stem cells can differentiate into red blood cells, platelets, and a group of white blood cells called granulocytes and monocytes. In myelodysplasia, the stem cells do not differentiate completely; they remain as immature “blast cells” instead of maturing into normal red blood cells, white blood cells and platelets. This results in a disproportionately low number of healthy mature blood cells, a condition known as cytopenia. When there is a shortage of red blood cells, this is called anemia. The corresponding deficiencies in the other cell types are called leukocytopenia (white blood cells) and thrombocytopenia (platelets).  Each of these deficiencies is associated with a host of health problems such as bleeding (caused by low platelet counts) and infection (due to low white blood cell counts). Besides the effects caused by a deficiency of normal blood cells, myelodysplasia often produces increased numbers of immature blast cells in the bone marrow. The accumulation of excess blast cells may result in some of the blasts becoming abnormal (their morphology, or form, is defective). This process is known as malignant transformation, and leads to leukemia. Hence, myelodysplasia is often considered to be a premalignant, or preleukemic condition, necessitating careful monitoring and intervention.    Myelodysplasia Symptoms Myelodysplastic syndromes often do not cause early symptoms and are sometimes found during a routine blood test. Although the symptoms below may be indicative of myelodysplasia, other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: Shortness of breath Weakness or feeling tired Pallor (pale skin) Easy bruising or bleeding Petechiae (flat, pinpoint spots under the skin caused by bleeding) Fever or frequent infections Splenomegaly (enlargement of the spleen)  Diagnosing Myelodysplasia Since myelodysplastic syndromes, or MDS, are diseases of blood and bone marrow, careful analysis of both is critical. Complete Blood Count (CBC) The CBC often provides the first signs that a patient has MDS by revealing unusually low levels of certain types of blood cells. A CBC measures the following: The number of red blood cells and platelets The number and type of white blood cells The amount of hemoglobin (the protein that carries oxygen) in the red blood cells The portion of the blood sample made up of red blood cells (called the hematocrit) Peripheral blood smear This is a procedure in which a sample of blood is checked for changes in the number, type, shape and size of blood cells, and for too much iron in the red blood cells. Bone Marrow Aspiration and Biopsy Knowing how many blasts are in the bone marrow is important to accurately diagnose the type of MDS the patient has. Therefore, a bone marrow aspirate and biopsy are necessary. For this procedure, a needle is inserted into the hipbone or sternum to obtain a small piece of bone and sample of bone marrow, which are then analyzed under the microscope. Cytogenetic Studies In cytogenetic studies, the bone marrow cells are examined for specific chromosomal abnormalities. The presence or absence of these markers can serve as a guide to prognosis and treatment.

today starts abbi's 4th cycle of azacitidine, we are in san francisco till friday. today is halloween and she was a little upset not to be at home with her friends, but we are gonna try and go trick or treating around here. and from 2 to 4 today is the halloween party at the family house, and it is pretty cool we were here last year. so she brought her costume, which is a devil, she chose to be about 5 different things before settling on the devil, one was being an angel which she has the costume for. but she looks very pretty in her devil costume. i kinda wished she would have chose the angel. well today is gonna be long, appointment at 10am she has her IVIG, dressing change, blood draw, doctor visit, chemo, oh and FLU SHOT! she hates shots so don't know how this one will go, been a while since she had one of those. but we don't want her getting that nasty flu, we will all be getting one, and no we are not requiring it this year for anyone else. she has been doing well since her last update, only 2 fevers, one of them sending her to mercy at home in redding for the night, yes we she got to be treated at home, her anc was good and the docs here felt as long as the blood cultures were negative as they were last time they would be comfortable treating her at her home hospital. she did have to have another blood transfusion though, which there has only been 2 since we started this chemo. so all in all mild side effects, but this chemo calls for at least 4 to 6 cycles to see an effect on her blood cells. it seems her asthma is acting up again, cough and wheezing. which has always been her only symptom. so chest xrays to rule out pnumonia, both negative. just asthma, she has not had a flare up in about 2 yrs. since right after her 2nd transplant. but i guess asthma symptoms can happen whenever they want. so i am gonna close for now and update when i can. Candi (Mom)

Flown in to UCSF for third time...

Saturday, October 1, 2011 8:42 PM, PDT

for those of you who don't know, abigail had a fever tuesday morning and was flown to UCSF because her white blood cells were low. she was put on two different antibiotics given blood and the next day was playing and acting her old self. she spent 3 days in the hospital with no fever. so they let her go to family house till her appointment on monday. so far she still has no fever and they don't know why she got one, nothing grew on the cultures, so maybe just a virus. she starts chemo again on monday, her 3rd cycle. we will go home on monday and finish chemo at home. she is doing very well, little side effects from the chemo. the hope is after her 3rd cycle her blood counts will start to come up, possibly 4th cycle. but soon we should see some positive numbers. i know we will. she is just full of energy, and feels a lot better. receiving the blood also helped a lot. her heart rate was very high while she was sleeping tuesday morning, a combination of her fever and low hemoglobin, which was 7.9 on monday dropped (with fever) to 6.9 so her heart has to work harder to pump oxygen to her blood cells. all of her numbers were up on monday and dropped with the fever. it is so crazy how things change from one minute to the next, literally. thanks to everyone who prayed. love you all

 

Abbi doesn't like the chemotherapy Olympics...

well abbi is on her last day of chemo for her 2nd cycle, we are sitting in hospital today cause clinic is not open, we are waiting for the chemo to get here. so i figured an update was overdue. anyway, things are good, since my last update abbi has become neutropenic, her wbc and anc has dropped, to be expected, but seems to be going up slowly again now. but her hemoglobin and platelets are dropping now. we have made it so far with no transfusions and we plan on getting through it with no transfusions. some good news is that she might be able to have this chemo in our hometown, so we are praying for that. would be such a nice break. my husband and son stayed home while abbi and i and a friend came down. and i have to say i am proud of dennis for holding down the fort while we were gone, bringing blake to school, going to work, cooking dinner, cleaning house. i have to admit i was nervous. but it all worked out. so after this chemo today we are headed home! excited and so ready to go home! so goodbye for today, Abbi's Mom

 

Abigail's Summer of outpatient Chemotherapy Treatments

just a quick update today, abbi is doing well. she has her next chemo sept 6th. if she does well and her blood counts don't drop too low, which they didn't this time, she may be able to go back to school. she is excited for this. she will be on meds to prevent sickness and infection. but this is promising news, and we are very happy. she is an amazing little girl. god is great! Mom

The hero is in you

Scorpions - Wind Of Change